NPIMap

Organization Active NPI

Montgomery Baptist Outreach Services Corporation

  • Family Medicine Physician
  • Montgomery, AL
National Provider Identifier
1770534901
Registry record updated Apr 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MONTGOMERY BAPTIST OUTREACH SERVICES CORPORATION
Practice address
4371 Narrow Lane Rd
Suite 100
Montgomery, AL 36116-2971
Phone
(334) 613-3680
Fax
(334) 613-3685
NPI assigned
May 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Christine Elizabeth Bruton
Title
Cfo
Phone
(334) 273-4258

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

4371 Narrow Lane Rd
Suite 100
Montgomery, AL 36116-2971

Mailing address

4371 Narrow Lane Rd
Suite 100
Montgomery, AL 36116-2971
Phone (334) 613-3680

Other identifiers 3

IdentifierTypeStateIssuer
0113048OtherALUNITED HEALTHCARE
CC9180OtherALRAILROAD MEDICARE
529904250MedicaidAL

Other names 1

  • MONTGOMERY FAMILY MEDICINE RESIDENCY PROGRAM Doing business as

National Provider Directory

National Provider Directory

Locations

440 Taylor Rd
Ste 3200
Montgomery, AL 36117
Phone (334) 213-6281

4371 Narrow Lane Rd
Ste 200A
Montgomery, AL 36116
Phone (334) 284-5211

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586390400000",
    "number": "1770534901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4371 NARROW LANE RD",
            "address_2": "SUITE 100",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361162971",
            "telephone_number": "334-613-3680",
            "fax_number": "334-613-3685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4371 NARROW LANE RD",
            "address_2": "SUITE 100",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361162971",
            "telephone_number": "334-613-3680",
            "fax_number": "334-613-3685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY BAPTIST OUTREACH SERVICES CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A",
        "authorized_official_last_name": "BRUTON",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "334-273-4258"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0113048",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC9180",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529904250",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MONTGOMERY FAMILY MEDICINE RESIDENCY PROGRAM",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MONTGOMERY FAMILY MEDICINE RESIDENCY PROGRAM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.